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international year of the disabled persons e the life and witness of the handicapped
. in the; Christian Community • concessions for the blind • medical ethics forum •
coping with illness > i. don't believe in pomp and glory • community health
seminar
•
rights of the
disabled
•
chai
news notes
•
medicartoon
International Year of the Disabled
Persons
THE U.N. General Assembly in 1976 proclaimed the year 1981 as the Inter
national Year of the Disabled Persons (IYDP). Its theme is Full Participa
tion and Equality.
The able and the disabled persons should co-exist, the former helping the
latter in all fieldsand professions discouraging and gradually eliminating
all compartmental treatments.
It is estimated that over 450 million people suffer from disability through
out the world. The year 1981 should help focus the attention of the
governments and voluntary bodies on the needs of these persons, what
ever they may be, and adopt remedial measures.
The observance of the year is aimed to achieve among others;
a.
Helping disabled persons in their physical and psychological adjust
ment to society;
b.
Promoting all national and international efforts to provide disabled
persons with proper assistance, training, care and guidance, to make
available opportunities for suitable work and to ensure their full integra
tion in society;
c.
Encouraging study and research projects designed to facilitate the
practical participation of disabled persons in daily life, for example, by
improving their access to public buildings and transportation systems;
d.
Educating and informing the public of the rights of disabled persons to
participate in and contribute to various aspects of economic, social and
political life;
e.
Promoting effective measures for the prevention of disability and for
the rehabilitation of disabled persons;
f.
Furthering the implementation of the 1971 Declaration on the Rights of
the Mentally Retarded Persons and the 1975 Declaration on the Rights
of Disabled Persons;
India has already spelt out her specific objectives which include among
others;
a. evolving a national policy on the disabled.
b. developing a strong national disability prevention programme.
c. providing a rural bias to services for the handicapped.
d. forming of cooperatives by the handicapped.
e.
2
conducting a sample survey of the
legislations.
handicapped and making
MEDICAL SERVICE
medical
service
official bimonthly house
journal of the catholic
hospital association of india
"the love of Christ
urges us" 2 cor. 5:14
vol. 38
no. 1
editor
contents
fr. john vattamattom svd
edl. assistant
v. j. mulanjanany
cover design
jan-feb. 1981
1.
international year of the disabled persons
2
2.
editorial
4
3.
the life and witness of the handicapped
in the Christian community
6
4.
concessions for the blind
13
5.
medical ethics forum-20
25
6.
coping with illness
27
7.
i don't believe in pomp and glory
35
8.
chai news notes
editor's note
39
community health seminar
41
p. m. isaac, bangalore
9.
printed and published by
the catholic hospital
association of india,
c.b.c.i., centre, goldakkhana,
new delhi-110001, and
printed at aruna printing
press, b-78, naraina
industrial area, Phase II,
new delhi 28
10. rights of the disabled
"Articles and statements published in this journal
do not necessarily reflect the policies and views of
the Catholic hospital association of India"
48
EDITORIAL
year of the disabled
A gentleman, wishing to do a fairly
comprehensive tour by rail, was pleasantly
surprised by the warm and friendly attitude
of the local station-master who spent a great
deal of time and energy helping him to
arrange the programme. A week later, wishing
to make some further adjustments in the
programme, he returned, and, to his
amazement, found the same station-master
rude and uncooperative. To his query about
the sudden change in attitude, the station
master, in a gruff voice, informed him : "Last
week was Railway Courtesy Week I"
them and they left Him happy and glorifying
God. Jesus did not stop merely at physical
healing or material caring. He went beyond
the physical disability to the hearts and souls
of men and women. Physical blindness was
also symbol of the blindness that cannot or
will not recognise God's glory. Lameness was
also a sign of man's spiritual infirmity,
impeding his progress towards God. There
are people who are deaf to the word of God
speaking in so many ways; and those whose
spiritual dumbness prevents them from
uttering the divine praises.
This little story might be a good way to begin
the celebration of the "Year of the Disabled."
We are constantly celebrating such "Years'*
—there was the "Year of the Woman," the
"Year of the Child" and many others—and
there is great danger that we might become a
little like that station-master. Some token
gestures will be made—some brave words
uttered—and after that, we will enter upon
the next "year." It is easy therefore to
become cynical about these celebrations.
No follower of Christ can do less. The
Church, which continues the work of Christ
in the world, has always striven to imitate
this dimension of the mission of Christ, : "to
the poor He preached the good news of
salvation, to prisoners freedom and to those
in sorrow, joy" (Eucharistic Prayer IV).
Already in the "Acts of the Apostles" we note
this concern, and the history of the Church is
dotted with innumerable saints who have
responded to the gospel imperative to care
for the disabled in any way. Cottolengo,
Elizabeth of Hungary, Vincent de Paul,
Damien the Leper, Mother Teresa, are some
names that come almost spontaneously to
mind. But there are a host of others in quiet
corners, hidden in their institutions, unknown
and unsung, who are caring as Jesus cared.
For them there is no such thing as a
"disabled." There is only the child of God,
His special friend, distined for eternal glory,
"able" to make his or her contribution to the
world in a particular way.
And yet, they have their function in calling
attention to realities which we ignore only at
our peril. Human minds are finite and limited
and the vastness of the problem areas of
human behaviour and human needs is likely
to make us, consciously or unconsciously,
turn a blind eye to some of these areas.
When one reads the gospels, one cannot but
be struck by the fact that Jesus Christ spent
a great deal of His time with the disabled.
They thronged on him from all sides, the
blind, the deaf, the dumb, the lame, paralytics,
people possessed by the devil or troubled by
issue of blood, lepers. Today's society will
have more sophisticated names for these
disabilities. The point is that Jesus healed
them all. He welcomed them, befriended
4
The "Year of the disabled" is an opportunity
also to focus attention on the transcendent
dimension of Christianity, its
"otherworldiness." To run ordinary schools,
even, I would say, ordinary hospitals, is to do
what everybody can do (and, to an extent, is
MEDICAL SERVICE
doing). Care of the disabled points
dramatically to the folly of the cross,
precisely because it contradicts the wisdom
of this world which tends to see all things in
terms of their material "efficiency." But a
world that rejects the disabled and does not
reach out to them is impoverishing itself in
the midst of affluence, it is gripped by
spiritual poverty and has lost its soul,
becoming an empty shell, ultimately to
disintegrate and dissolve in its own
selfishness.
There is, however, danger that care for the
disabled can itself become an empty shell,
mere ritual, conforming to a fashion of the
word to indulge in "social work" as a bandge
of social respectability. These are hard words,
no doubt, and they run the risk of rash
judgement. But the danger remains. And it
can afflict even the Church and her
institutions if the love of Christ and
fellowmen is not constantly renewed. Care
for the disabled, paradoxical as it may appear,
is not primarily care of physical disability,
but it goes beyond to the full rehabilitation
of persons, sensing their dignity as children
of God and therefore cooperating with their
Creator in making a better world. If the
Church does not seek to do this, she fails in
her mission and betrays the gospel. Her work
becomes mere philanthrophy which, for all
the publicity it may receive, is sounding brass
and tinkling cymbal. It is not Christian love.
The "Year of the Disabled" challenges all our
member-institutions to reach out to the
disabled of all kinds but especially to those
disabled for whom, so far, little has been
done. But it is also a challenge to every
Christian, as indeed to all men and women of
goodwill, to reach out to the disabled and be
privileged to work side by side with them for
the rehabilitation—nothing less—of society at
large.
Msgr. Eustace D'Lima
PRINCIPAL CAUSES OF DISABILITY
a. Accidents
b. Crippling diseases
c. Leprosy
d. Malnutrition
e. Vitamin deficiencies
f. Mental illness
g. Blindness
h. Deaf and Dumb
i. Cerebral Palsy
j. Epileptics
k. Cardiovascular diseases
I. War.
The May-June 1981 issue of Medical Service will highlight the
various efforts of Catholic Institutions in caring for and rehabilitating the
disabled persons including the aged.
We request you to furnish us with informations regarding your works,
write-ups, anecdots and photographs for favour of publication. Thanks
Editor
_______________________________________________
JANUARY-FEBRUARY '81
■_
I
5
The life and witness of the
handicapped in the Christian
community
Introduction
where these brothers and sisters are treated
as objects of condescending charity. It is
broken where they are left out. How can the
love of Christ create in us the will to discern
and to work, forcefully against the causes
which distort and cripple the lives of so many
of our fellow human beings ? How can the
Church be open to the witness which Christ
extends through them ?
THE Fifth Assembly of the World Council of
Churches in Nairobi in 1975 declared in
one of its official reports under the heading
of "The Handicapped and the Wholeness
of the Family of God," that : "The
Church's unity includes both the
'disabled' and the 'able'. A church
which seeks to be truly united within itself
and to move towards unity with others must
This declaration provided the background for
be open to all; yet able-bodied church
a consultation held in Bad Saarow, German
members, both by their attitudes and by their Democratic Republics, 3-7 April 1978, on the
emphasis on activism, marginalize and often
theme, "The Life and Witness of the
exclude those with mental or physical disabi Handicapped in the Christian Community."
lities. The disabled are treated as tha weak
This meeting was sponsored jointly by the
to be served, rather than as fully-committed, Inner Mission and Hilfswerkof the Evangelical
integral members of the Body of Christ and
Churches of the GDR and the World Council
the human family; the specific contribution
of Churches (Commission of Faith and Order;
which they have to give is ignored. This is
Commission on Inter-Church Aid, Refugee and
' more serious because disability—a world
. World Service; and the Christian Medical
wide problem—is increasing. Accidents and
Commission). .Thirty eight participants from
illness leave adults and children disabled;
fifteen countries met in this consultation.
many more are emotionally handicapped by
Most of them were people directly engaged
the pressures of social change and urban
in the work with the disabled; some were
living; genetic disorders and famine leave
themselves, physically handicapped.
millions of children physically or mentally
The following abbreviated report of the
impaired. ,The Church cannot exemplify 'the
full humanity revealed in Christ', bear witness consultation contains the insights, experience
and recommendations of the participants :
to the independence of mankind, or achieve
’unity in diversity if it continues to acquiesce
I. 1. We commit ourselves to the
in the social isolation of disabled persons and
conviction that full acceptance of
to deny them full participation in its life. The
persons with handicaps within the
unity of the family of God is handicapped
6
MEDICAL SERVICE
life, witness and service of the
church is a requirement for the
wholeness of the family of God.
We view this consultation as a
contribution to the task of
demonstrating and furthering the unity
of Gad's family by what we do
together as disabled and able-bodied.
2.
The wholeness of the family of
God on which Nairobi laid such
emphasis implies the full
acceptance of the disabled in the
life, witness and service of the
Church. This full and unconditional
acceptance of the handicapped must
be made a reality at the very heart of
the Church's life.
3.
When we confess our belief in the
complete oneness of all human
beings in the family of God, we
are clearly affirming that no one
may be excluded or excempted
from it, however severely
handicapped. No physical, mental
or sensory disability may be made a
pretext for denying this solidarity.
There is no Christian community
without the disabled. When the
handicapped are missing, the
community itself becomes
handicapped.
4.
Our Lord Jesus Christ identifies
Himself with the handicapped.
In them. He encounters the
community, just as He discloses
Himself to us in all those who are
outcast, all who suffer, all who
are despised. The Christian
community is constantly summoned
to gather together around its Lord. It
is the permanent task of the
Christian family to gather and to
integrate all the members of His body.
JANUARY—FEBRUARY '81
It is right to speak, therefore, of a
constant mutual integration of the
disabled and the able-bodied.
5.
The consequences for the life of
the Church are evident, in both
worship and service, and affect
the ordained as well as the lay
leadership. Starting from the
assumption that the presence and
participation of the disabled is the
normal case and not the exception,
we ask for forms of worship which
are appropriate to the ways in which
disabled people can express
themselves. We doubt most strongly
that there are reasons to prevent
baptized disabled persons, regardless
of the kind of disability, from the
Lord's table. Equally strongly, we
must assure the accessibility of
disabled people to the ordained
ministry.
6.
The unity of all human beings,
irrespective of their handicaps,
is a sign of the preservation of the
world from inhumanity. The
presence of the disabled reminds
us that every human being is a
frail and threatened being and a
being created and blessed by God.
When those who are able-bodied
remove their disabled fellow human
beings to a ghetto-like existence in
homes or institutions, or abandon
them to isolation and loneliness in
their own homes, all-are in danger
of losing the opportunity of
partnership and the full richness of
human experience.
7.
Fellowship between the disabled
and the able-bodied makes it
easier for all to be realistic and
honest in admitting that no life is
7
exempt from handicaps of some
sort. A sharp distinction between
the 'handicapped’ and the 'healthy'
prevents the recognition that every
human being, at some time or many
time-in the course of life, if only in
old age, must contend with
disability.
II. 1. In thus affirming our conviction
that the unity and integration of
the disabled in the church are
based on the Gospel of Christ,
we affirm also the continuing need
for institutions in which the most
severely disabled experience help
protection and care. We
acknowledge with gratitude the help
and the home which such places
provide for thousands of disabled
human beings, and that in these
institutions new and improved
therapeutic methods, technical aids
and nursing systems have been
developed which have become an
indispensable aspect of the work with
the disabled today.
2.
Action for prevention of
disability is a critical demand not
only for secular governments but
also for the church. We urgently
request ecumenical organizations,
churches and development agencies to
include the prevention of disability
among their priorities for intensive
and wide-ranging effort. In many
countries of the world, disability
prevention efforts are completely
lacking or only at a very
rudimentary stdge. According to
estimates made by the World Health
Organization and other organizations,
10 per cent of the world's population
is disabled (i.e. 400 million human
beings). It is also estimated that more
JANUARY-FEBRUARY '81
than half of these disabilities could
be prevented by overall preventive
measures. If the number of disabled
people is to be reduced, in Third
World countries especially, among
the most important steps required are:
adequate and balanced diet, health
care among mothers and small
children, inoculation programmes,
sanitary measures, safe and available
water, education and hygiene.
Therefore, the emphasis must be on
preventive measures.
3.
4.
We are convinced that, in
cooperation with government
bodies and voluntary welfare
organizations, the churches must
develop comprehensive patterns of
preventive rehabilitation as a
matter of urgency. The people in
the villages and towns can help here
in more ways than is sometimes
expected of them. Within these
overall patterns, the specialist
institutions, clinics and rehabilitation
centres can also find an important
and even financially viable role. In
many cases this will entail a radical
shift in the direction of their work
and a reallocation of funds and
resources.
With regard to the situation in
Europe, we wish to draw attention
to the need to continue supporting
the services of the churches with
and for the disabled in institutions
and rehabilitation centres. The
whole church owes its members in
these institutions the continuing
ministry of intercession. Among the
responsibilities of the churches is to
help to provide sufficient personnel
for this vital and difficult work, to
offer training and retraining, and to
9
facilitate an ongoing exchange of
information and experience. A
constant effort must also be made to
ensure improved living conditions in
therapy and work. Sections 9 of the
United Nations "Declaration of the
Rights of the Handicapped" per
states : "When a handicapped person
is unavoidably placed in a specialized
institution, the environment and
living conditions should as far as
possible be comparable with those of
a person of similar age living a
normal life." This would suggest, for
example, that the creation of
hostel-type accommodations and
residential homes for mentally and
physically handicapped young people
is needed, preferably together with
able-bodied young people.
move to a dramatic affirmation
of congregational acceptance of
the handicapped within the
mainstream of congregational life.
The criterion of life in the Christian
community must be whether or not the
disabled really share fully in that life.
The church loses its credibility when
its proclamation of the unity of all
Christians is not matched by a shared
life in the fellowship of the Christian
community. But the task of mutual
and continuous integration of the
handicapped into the life of the
church implies the destruction of
many barriers to achieve that goal.
2.
HI. 1. But the church must go beyond
the institutional response and
The greatest barrier is found in
prejudices and attitudes.
To a large extent, disabled people
are emotionally rejected people. Other
people do not quite know how to deal
with them. They shy away from them.
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in a reaction or horror of fear. The
ideal figure of the young, athletic,
fully productive human being leads
them to disparage the handicapped
person as a second-class human
being. The Christian community must,
therefore, be or become the place
where these prejudices and attitudes
are uncovered and changed by a
human ideal which takes its direction
from Jesus Christ as the suffering
servant of God and the brother of the
poor and despised.
3.
4.
The barrier of pity is particularly
disrciminating to disabled people.
When anyone commiserates with
a disabled person as an
'unfortunate* pitiable human being.
This immediately creates a
gulf between them. A
condescending pity springs from a
sense of superiority or fear, and
reinforces feelings of inferiority in
the disabled person. Apart from the
fact that pity tends to evaporate
fairly rapidly, it also establishes a
pattern of paternalistic aid and thus
results in a relationship of
dependency which the disabled
person rightly rebels against. But in
the Christian community, all belong
together as equally respected
persons, irrespective of the degree
of disability.
The barriers set up by forms of
worship and liturgy must be
broken down.
The services must be so designed
that the disabled can participate. In
this respect each liturgical tradition
will have to ask itself different
questions. But in each case the
communal character of worship
needs to be more strongly focused.
JANUARY—FEBRUARY '81
5.
Congregations should consider
taking a stance of advocacy for
and with the handicapped.
Congregations which seriously try to
overcome their own barriers can also
become credible champions of the
handicapped. As partners, church
and handicapped may present their
common needs to the general public
in the local communities and
elsewhere.
6.
The architectural barriers must
be removed. We urge church
authorities and congregational
councils to ensure that the house and
the altar of God are made accessible
to the disabled as well as the ablebodiea. Churches and Church
premises should be so designed that
handicapped people can feel at home
in them.
7.
Overcoming the sense of
isolation of the handicapped is
a particular responsibility of the
church. One particular important
task is the regular visitation of the
disabled and their parents, spouses,
and relatives, and sharing in their
struggle against loneliness and
embitterment and with day-to-day
difficulties. Members of the family
need regular periods of relief from the
nursing of their disabled member (for
example, by home helps). Parishes
should also consider arranging joint
holidays, outings and excursions.
8.
Sensitivity to the situation of
disabled fellow human beings
must be developed in the teaching
and catechetical work of
congregations. This training in
sensitivity must begin in the
kindergarten and continue in the
11
Sunday School and in other teaching
activities.
9.
The majority of Christians and
society generally tend to regard
the search for partnership and
the sexual needs of disabled
persons with incomprehension
and rejection. We must, therefore,
make it a rule for ourselves, and ask
the churches to do the same, to
react with a wholistic ethical
response, and not with a moralistic
or legalistic bias, when handicapped
persons seek novel solutions which
may perhaps appear shocking to us.
We must put ourselves in the place of
the disabled person and ask ourselves
what expression is open to, and
would be a responsible one for him
or her of the disposition which God
has given to us all.
10.
Like their peers, young disabled
persons especially strive for
independence and autonomy.
Our question therefore is; can
congregations help to ensure that
residential homes are built in which
physically and mentally disabled
young people can share life with
able-bodied young people as
independently as possible ?
11.
We frequently note that pastors
priests and church workers have
an inadequate understanding of
the disabled person and his or her
situation. There is a striking gap
here in theological training. Therefore,
we call upon the churches to study,
in depth, the theological and
ecclesiastical understanding of the
church in reference to the
Courtesy' CONTACT—The bi-monthly
bulletin of the Christian Medical
Commission of the World Council of
’ Churches, Geneva. (Special series No. 2,
June 1979)
12
handicapped, to emphasize the
Pauline insistence of God's
expressing His strength the weakness,
and of Jesus insistence upon the
inclusion of "the poor, the maimed,
the blind in the great feast of the
Kingdom."
IV.
What should be the next steps ?
We are grateful for the cooperation
between a number of sub-units of the
World Council of Churches and the
Inner Mission und Hilfswerk of the
Evangelical Churches in the German
Democratic Republic which made
this consultation possible. We regard
the consultation as the first of many
such ecumenical initiatives. Among
the future tasks and requirements are:
1.
Action which can be started by all
churches:
Ecumenical exchange of experience
and results of research, with the
participation of disabled persons, and
including the Roman Catholic Church.
Support of minority churches in
their work with the disabled;
more through study of disability
prevention, in close cooperation with
other international organization such .
as the World Health Organization
and Rehabilitation International.
2.
Specialist conferences should study
the following problems :
Opportunities and models for the
integration of disabled persons in
the life of the churches; Partnership
and sexuality among disabled people,
and counselling methods;
Religious instruction of mentally
disabled children and adults;
provision of ecumenical curricula
and materials the development and
diffusion of new forms of worship
which do justice to disabled persons.
MEDICAL SERVICE
CONCESSIONS
FOR
THE BLIND
For the benefits of especially those who are engaged in the rehabilitation
of the blind, we give below the various concessions granted to the blind.
Details of the concessions given to the handicapped will be published in
the March-April issue.
1 Travel by Air
The Indian Airlines Corporation allows the
blind a concession of 50% in the fare on
domestic air flights. No concession is
available on international flights by Air India
or any other International Airlines.
Blind passengers will have to make an
application for grant of 50% concession and
such applications must be accompained by
a certificate from a registered medical
practitioner testifying to the fact that the
person is blind and has lost the vision of
both eyes. Such certificate must also carry
the registered number of the registered
medical practitioner of the State to which
he/she belongs.
concessional fares to the blind. The details
are as follows :—
2 Travel by Sea
Some shipping companies have offered
The Mogul Lines Limited :
Prepared to consider each case on its merits.
Scindia Steam Navigation Co. Ltd. :
Only {th of the basic nett fare will be
charged if travelling alone.
Eastern Shipping Corporation :
Prepared to consider each individual case on
its merits in consultation with B.l. with
whom they have passenger services jointly.
Bombay Steam Navigation Co. Ltd.:
{th of the basic nett steamer fare will be
charged when a blind person travels alone.
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Travel by Railways
The Ministry of Railways allows the blind to travel at concessional fares on the
Indian Railways as per details below. We reproduce the relevant forms required to be filled
for information and utilisation of these concessions.
Persons, etc.,
eligible
Circumstance, under Authority on which Nature of
which concession concession will be concessions
is admissible,
allowed by the Stasubject to condi- tion Master
tions shown in
Clauses (1) to (12)
of Rule 101
3
(1) Blind per
sons accom
panied by an
escort.
4
On production of a Single Journey
certificate from :
Tickets
Remarks
5
(1) the form 0
certificate is
shown in Appen
dix 1/16
(1) A registered
Permission to
(2) The conces
medical practitioner travel accompa sional tickets
(2) Heads of the
nied by an escort may be issued by
institutions for the on payment of
the Station
Blind recognised by one single jour Master on colle
the Ministry or Edu ney fare for the
ction of
the
cation (List of Insti blind in the class certificate (Ap
tutions is shown in occupied; Mail
pendix 1 /16)
Appendix 1/15)
fares being char after verifying
ged in the case of that the certifi
Second Class. An cate is complete
escort accompa in all respects.
nying a blind
child aged 3
years and less
shall be charged
at half the public
tariff rates.
Return Journey If instead of the
Tickets permis original certifi
sion to travel ac cate a copy of
companied by
the certificate
an escort on
duly attested by
payment of dou by a Gazetted
ble the single
Officer Magist
Journey fare for rate or Member
the Blind, in the of Parliament or
class occupied; a State LigislaMail fares being ture is produced,
charged in the
the ticket may be
case of Second issued on collec
Class An escort tion of the certi
accompanying a fied copy but at
blind child aged the time of issue
JANUARY—FEBRUARY '81
15
3
3 years and less
shall be charged
single Journey
fare of the class
occupied
of the ticket the
original certifi
cate should be
inspected.
It is not necess
Note-period of
ary for the blind
availability of
return tickets will person concer
be as laid down ned to be pre
sent at the sta
in Rule 215 of
I.R.C.A. Coaching tion for purchas
ing the ticket.
Tariff No. 22,
Part I (Volume I) (3> The particuclars regarding
the age, sex and
identification
marks should be
copied out from
the certificate
on the Blank
Paper Ticket
issued to the
Blind.
(2) Blind
persons
travelling
alone
On production of a Single Journey
(4) A combined
certificate from :
Blank Paper
tickets : Single
(1) A registered Journey tickets on Ticket should
medical practitioner payment of one
be issued for the
(2) Heads of the in fourth of the fare Journey of the
stitutions for the
due : Mail fares blind person and
Blind recognized
being charged in his escort.
by the Ministry of the case of
Education (List of Second Class.
Institutions is
Return Journey
shown in Appendix Tickets.
1/15)
Return Journey
tickets on pay
ment of double
the concessional
fare for single
journey; Mail
fares being
charged in the
case of Second
Class.
Note-period of
availability of
return tickets
will be as laid
down in Rule
215 of I.R.C.A.
16
(1) The form of
certificate is
shown in Appen
dix 1/16.
(2) The conces
sional tickets may
MEDICAL SERVICE
Coaching Tariff
No. 22 Part I
(Volume I)
(3) Blind per
sons under the
care of reco
gnised insti
tutions accom
panied by an
escort. (List
When travelling
of Institutions between their
is shown in homes
JANUARY-FEBRUARY '81
be issued by the
Station Master
on collection of
the certificate
after verifying
that the certifi
cate is complete
in all respects.
If instead of the
of the original
certificate a
copy of the cer
tificate duly at
tested by a Ga
zetted officer a
Magistrate or a
Member of Par
liament or a
State Ligislature
is produced, the
ticket may be
issued on colle
ction of the
certified copy
but at the time
of issue of the
ticket the origi
nal certificate
should be inspe
cted. it is not
necessary for
the blind person
concerned to be
present at the
station for pur
chasing the
ticket.
•
(3) The ticket
should be endor
sed "At conces
sional rate for
blind persons.
On production of a Permission to
The form of cer
letter of authoriza travel accompani tificate for sea
tion signed by an
ed by an escort- son ticket is
authorized officer On payment of the shown in
of the Railway
season ticket fare Appendix 1/17
vide Rule 101 (6) (either suburban
On production of as the case may
a letter of authori be) of the class
occupied.
zation signed by
17
2
1
Appendix
1/15)
and
(1) the school coll
(4) Blind
pupils in par ege or institution
ties if not less in which they re
than four stud ceive education,
ying in scho and (2) a place of
ols, colleges vacation, on produ
or institutions ction of a certifi
which are re cate signed by the
cognized by
Head of a school,
the Education college or instituDepartment of tion recognized by
the State in the Education Dep
which the
artment of the
schools are
State or bythe
situated.
Ministry of Educa
tion
3
4
an authorized
officer of the Railway vide
Rule 101
(6)
“
5
Fare (1) the form of
for certificate is
shown in AppeAdults Childern ndix 1/18.
below (2) Each party
12 and must travel toover 3 get her in the
years
same train but
not necessarily
in the same
class of carriage,
vide Rule 101
(11)
First
30%
60% of of the
the
normal
normal fare
fare
Quarter
Second of Second
Half of class Mail
Second fare
class
Mail
Class Fare
for
fare
Free ticket for
(3) The number
one escort for
in the party may
the every two
be increased or
pupils in the
decreased on
same class of
route provided
carriage whether the minimum of
the pupils hold four is maintaiadult tickets or ned throughout
half tickets
the journey or a
minimum fare
for four is paid
for upto the
destination.
18
MEDICAL SERVICE
APPENDIX 1/16
(See Rule 101 Serial Nos. 11(1) and 11(2)
Appendix 1/16
Certificate for Blind
(to be used by a
Registered Medical
Concession Certificate
Practitioner Heads of
the Institutions of the
Blind recognised by
the Ministry of
Education)
FORM FOR THE PURPOSE OF ISSUE OF RAIL CONCESSION TO THE BLIND TO BE
USED BY A REGISTERED MEDICAL PRACTITIONER OR HEADS OF THE INSTITUTIONS
FOR THE BLIND RECOGNIZED BY THE MINISTRY OF EDUCATION :
This is to certify that Shri/Shrimati
furnished below is a completely blind person.
Particulars of the Blind person :—
(a) Age :
(b) Sex :
(c) ’Personal identification Marks: (1)
(2)
(d) Left hand thumb impression or
signature of the Blind person :
Station
Date
particulars of whom are
...
Signature of the Registered
Medical Practitioner/Heads
of the Institutions for the
Blind recognized by the
Ministry of Education.
Regd. No. of the Medical Practitioner
OR
Office Stamp of the Institution for the Blind
♦The personal marks of identification should be such as can be easily verified, if necessary
by Ticket Checking Staff.
Note: (1) This certificate will be valid only for a period of three years from the date of
issue.
(2) A copy of the certificate, duly attested by a Gazetted Officer, a Magistrate,
or a Member af Parliament or State Legislature will also be accepted but
this certificate in original should be produced for inspection at the time of
purchase of the ticket.
JANUARY-FEBRUARY '81
19
APPENDIX 1/17
Appendix 17 >
Concession
Concession Certificate
Certificate for the
Blind
FORM FOR THE PURPOSE OF ISSUE OF CONCESSION FOR THE BLIND. (OTHER THAN
STUDENT) TO BE USED BY THE HEAD OF THE INSTITUTION FOR THE BLIND RECO
GNIZED BY THE MINISTRY OF EDUCATION
• • This is to certify that
..
a member of the
Institution is a bonafide blind person under the care of the institution and intends travell
ing from
.................... (station) to
(station). He/She
is being accompanied by......................................
as his/her escort.
(See Rule 101, Serial No. 11 (3))
v
Head of the Institution.
FORM TO BE USED BY THE BLIND PERSON CLAIMING THE CONCESSION
To :
The
........................
(Railway)
... (Station) ‘
Dear Sir,
With reference to the above certificate, I understand that I am entitled under the
Rules of Your Railway to a concession order enabling me to obtain a season ticket as
follows":—
;
To travel accompanied by an escort.
On payment of 1J season ticket fare in the case of season ticket (either suburban
or non-suburban as the case may be) of the class required.
Will you please send me (to the address given below) a concession Order available
upto
...?..... 19
Yours faithfully.
FORM TO BE USED BY THE OFFICER ISSUING CONCESSION ORDER
Railway
Concession for Blind Persons
Dated
No
To
The Station Master,
19
On presentation of this Concession Order, issue to
a member
of
Institution one season ticket for himself/herself accompanied by. an
escort from
(station) to
(station) on payment of
1} season ticket fare in the case of season ticket (either suburban or non-suburban as the
case may be) of the class required.
This concession order is available upto
19
District.
The Divisional Superintendent/
The Dist. Traffic Superintendent.
Received
.......... .
Class Ticket No.
Date
..........
Signature/Thumb Impression of the
blind person.
.20
MEDICAL SERVICE
APPENDIX I/18
(See Rule 101. Serial No. 11 [4])
Appendix 1/18
Concessions for Blind
Students
CONCESSION CERTIFICATE
CERTIFICATE FOR OBTAINING CONCESSION FOR BLIND STUDENTS AND SCHOOL
CHILDREN WHEN TRAVELLING IN PARTIES OF 'NOT LESS THAN FOUR'
From :
Office stamp of the
School or College
To
The Divisional Superintendent,
The District Traffic Superintendent,
(Railway)
(Station)
School Children
Students
This is to certify that
(No. in words)
named below are bonafide blind students of school/college/institution are proceeding
from/to their school/college/institution/homes in India to/from
homes
their place of vacation
examination centre in India
They are travelling from
(station) to
(station) and
a Concession Order for their journey may please be issued available upto
19
(probable date of starting)
Note
Entries not required should be crossed out.
No.
Names of Students
Sex
Age
1.
2.
3.
4.
5.
6.
No. of escorts
Station
Date
JANUARY-FEBRUARY '81
(Maximum one allowed free for every two Children)
(to be inserted in red ink)
Head Master/Principle
(Form to be used by the Officer Issuing Concession Order)
CONCESSION LETTER FOR BLIND SCHOOL CHILDREN AND STUDENTS IN PARTIES
OF NOT LESS THAN FOUR
No
.......... ’
Dated
19
To
The Station Master
Please permit the blind school children or adult students named below numbering
not less than four in any case, to travel from
to
with one escort
free for every two blind school children or adult students as endorsed in red ink at the top
of this form and signed by the issuing Officer paying fares at the following scale :—
Class
Fare for Adults
First
Second
60% of the normal fare
Half of Second Class
Mail Fares
Fare for children below
12 and over 3 years
30% of the normal fare
Quarter of Second Class
Mail Fares
The party must travel in the same train, but not necessarily in the same class of
carriage.
This concession letter will be available upto
19
Divisional Superintendent
Dist. Traffic Superintendent
Division/Dist.
The issuing officer must be careful to endorse the number OT^cJfibrts in words and
also sign the endorsement.
Name of School or College
.................................
1.
2.
3.
4.
5.
NAME OF CHILDREN
6.
7
8.
9..
10.
Travel by State Transport Buses
The following State Transport Corporations have granted concessions to blind
commuters.
1. Gujarat State Road Transport Corporation grant a concession of 75% to the
Blind persons and to their attendants.
2. Jammu and Kashmir Road Transport Corporation, Srinagar allows 50% conces
sion in fare to the deaf, dumb and blind persons.
JANUARY-FEBRUARY '81
• -
23
Karnataka State Road Transport Corporation allows the blind to travel free in
city buses and at 50% concession in case of mofussile and suburban services
on the authority of an identity card issued by the Unit Head.
4. Madhya Pradesh State Transport Corporation permits blind person to travel free
of cost. But the escort/s may pay one forth of the fare.
5. Maharashtra State Transport Corporation provides for 75% concessional travel
by the blinds for purposes other than begging. In order to avail the facility, the
person concerned must carry a certificate duly issued by :
(i) an institution or association working for welfare of the blind or (ii) Hon.
(or otherwise) Medical Officers appointed by the corporation for its dispensaries.
6. The Government of Orissa grants 50% concession to blind students on proper
identification issued by the Head of the Institutions.
7. Handicapped persons in the State of Punjab who are in possession of identity
cards issued by the Deputy Commissioner of the district concerned are charged
50% of the Normal Charges of the State Transport Services.
8. Rajasthan Road Transport Corporation offers free of cost travel to the blind on
the production of a certificate issued by Head of any institution for the blind
where the blind person is receiving education. Head sar-panch of Gram Panchayat or a local Gazetted Officer.
3.
Travel by City Buses
Blind persons can travel free in city buses of Ahmedabad and Poona and at con
cessional in Bombay. As information in this regard are incomplete, the concerned persons
may contact their perspective municipal corporations for information.
Income Tax Concessions
The Gover,ix: ~>t of India allows the blind a generous deduction of 10,000 from total
income when computing the net income.
Postal Concessions
Literature for the blind is exempted from the payment of postage, both inland and
foreign.
Similarly institutions for the blind are exempted from the payment of Wireless
Licences Fees.
Customs Concession
Institutions for the blind are permitted to import equipment and apparatus required
for the education and training of the blind, free of customs duty if such equipment and ap
paratus are received as bonafide gifts. For this purpose, the institution is required to obtain
a Customs Clearance Permit from the Chief Controller of Imports & Exports, Udyog Bhavan,
New Delhi. To obtain a Customs Clearance Permit an application should be made in
Form B (for actual users) along with which should be attached a letter in original from
the donor. No fee is required to be paid by charitable organizations when applying for a
Customs Clearance Permit. This concession is not available to individuals.
24
MEDICAL SERVICE
medical ethics forum-20
FR. GEORGE V. LOBO S.J.
.
;
Informed Consent
Q.N.3 of the Patients Bill of Rights (cf.
Medical Ethics Forum-19) states that "the
patient has the right to receive from his
physician information necessary to give
informed consent prior to the start of any
procedure andfor treatment** What is the
scope of this information?
The required information cannot amount to
#/full disclosure". It would be unrealistic
to expect physicians to discuss with their
patients every risk of the proposed treatment,
no matter how small or remote. Some would
measure the required disclosure by "good
medical practice". Others by what a
reasonable practitioner would have dared
under the circumstances. Such a standard
based merely on a so called professional
standard would go against the patient's
prerogative to decide on projected therapy,
himself.
The patient's right of self-decision should
shape the boundaries of the duty to reveal.
That right can be effectively exercised only
if the patient possesses enough information
to enable an intelligent choice.
The content of the disclosure rests in the
first instance with the physician. Ordinarily,
it is only he who is in position to identify
particular dangers. But on the basis of his
experience and the knowledge of his
patient's background and current condition,
he should be able to sense to what extent
revelation to the patient would be helpful
for the purpose of giving informed consent.
The materiality could be defined in the
following way. "A risk is material when a
reasonable person, in what the physician
knows or should know to be the patient's
condition, would be likely to attach
significance to the risk or cluster of risks in
deciding whether or not to forgo the
proposed therapy."
The areas demanding a communication of
information are the inherent and likely
hazards of the proposed treatment, the
alternatives to that treatment, if any, and
the results likely if the patient remains
untreated. The advantages of the treatment
as well as the costs would also be material
to the decision.
There are two exceptions to the general
rule ol disclosure. The first comes into play
when the patient if unconscious or otherwise
incapable of consenting, and harm from a
failure to treat is imminent and outweighs
any harm threatened by the porposed
treatment. If possible, a relative's consent
should be obtained.
The second exception obtains when the
disclosure about the risk poses such a thre t
of detriment to the patient as to become
contra-indicated frorif»rnedic.al point of
view. Occasionally, patients become so ill or
emotionally distraught on disclosure that
they would be incapable of rational decision,
or complicate the treatment. The disclosure
may even pose psychological damage to the
patient.
Such exceptions, however, do not justify a
paternalistic attitude in normal cases on the
part of the physician. The right of the
patient to make an informed decision should
be safeguarded.
A Verbal explanation may be sufficient. But
to avoid legal complications, a written
25
JANUARY-FEBRUARY '81
(OT^njNlTY HEALTH CEU
326. V Main, i Slock
Koramengala
Bangalora-56uQ34
__
Ifidia _ ------------ -
COPING WITH ILLNESS
A Time for Healing
FROM time to time each one of us is in the
presence of illness. Whatever our role, we
can participate in healing—both healing of
the body and healing of the spirit.
"To heal", says Robert S. Brown, a physician
involved in hospice care for the terminally
ill, "Zs to enable the patient to...realize
himself, whatever his physical condition,
as a whole person."
Caring people, lay and professional, sense
the needs of the spirit. When they see each
other as partners in healing, that healing
broadens and deepens and can even go
beyond the patient. Such people then
become a healing community.
"A nurse", writes Mary Kaye Dunn, R.N.,
"at any one time is both...*healer' and "one
who is healed". In the experience of illness,
whoever and wherever we are, we need
each other.
The Experience of Illness
In the presence of illness we are all human
beings, each-even medical professionals
bringing to the sickroom our own bundle of
attitudes, fears, needs and past associations.
Most of us feel some discomfort, may be
anxiety.
A relationship may shift, a family pattern
change, defenses slip or stiffen, the new
statement could be provided. The patient
could also be given the choice of knowing
or not knowing the risk by including in the
form (for consent) a item somewhat as
follows;
"The procedure which you are scheduled
has some significant hazards attached with
JANUARY-FEBRUARY '81
situation trigger an unexpected emotional
response.
We may feel: Loss of Competence. A patient,
"They're all telling me what to do. I've lost
control of my own life. I feel like a child."
ill at ease. A man with a friend who is
seriously ill : "I don't know what to say or
do when I go to see him, I feel helpless."
Depersonalized. A hospital patient: "I feel
the need for reverence for me as a person
instead of a piece of stuff, stripped and
numbered."
Vulnerable. A nurse : "People have said I'm
cold. I just can't afford to get emotionally
involved. I can't handle it."
Afraid. A child in the hospital : "I'm afraid
to be alone. Why did they leave me? I want
my 'mommy'."
Angry. A patient after an open-heart surgery:
"I was fighting with everybody...! was angry
at my frailty."
There may be :
Change in Relationship. The husband of a
cancer patient: "I feel lost...as if a wall has
come up between us..." .
Misunderstanding. A patient's wife didn't
understand a change in her husband's
behaviour: "The doctor said, 'He's getting
along nicely." I guess he couldn't tell me
it. Your doctor is aware of these risks and
feels that the diagnostic information
obtained outweighs the possible risks of
the procedure. If you want information
concerning risks and complications, please
note below."
27
my husband was getting ready to die. It
would have helped so much."
How can we help each other cope with
illness? We can begin by trying to become
healing persons.
•P-
Becoming a Healing Person
The root for the words hospice, hotel,
hospital, hospitality is the Latin word
hospes. It means both host and guest.
Henri Nouwen, author of "Reaching Out,"
calls healing a form of hospitality. It is
creating space for the other person. "We are
all healers who can reach out and offer
health," he writes, "and we are all patients
in constant need of help."
In the sickroom, a paticular doctor or nurse,
though professionally competent, may not be
a healing person, while a caring relative
could provide a strong healing presence
Anyone can become a healing person.
We can work at :
Being fully present to each other. "The more
carefully I listen to patients, "says Connec
ticut physician Morris J. Wessel, "I sense
an undercurrent of pleading..."! sense tired,
I am in pain. I'm lonely. There is so much I
must talk about"
Accepting patients on their own terms.
"Treat me as a well person," pleaded a
leukemia patient. "Include me in your
activities. Ask me out, hire me..."
Communicating fully, seeking and giving
information, sharing feelings. A nurse
relieved the anguish of a seriously ill patient
whose wife pretended everything was all
right, each spouse thinking the other
"couldn't handle it," She helped them to be
able to cry together, talk about it and find
release.
Being sensitive. With much agitation, a
senile nursing home patient whispered to a
young volunteer that there was a may under
JANUARY-FEBRUARY '81
her wheelchair. The girl began to yell "man"
to leave her alone. In a few minutes the
woman said, "There he goes. Thank you so
much. He's been bothering me a lot lately."
Admitting vulnerability. A dying man asked
the newly graduated nurse to talk with him.
"I' can't," she said. "I'm too afraid." Her
candor elicited his reassurance that what she
said didn't matter. She learned that it was
enough just to sit with him.
Facing, perhaps adjusting, our attitude
towards death. "Hospice," the name for
medieval havens for the dying, signified that
the doors were open to the traveler on his
journey from one life to the next.
Many do look upon death as an opening
door. Others think of it as the end of
everything. Some doctors and nurses see
death as a failure. Many of us have fears
about it.
Our feelings and our beliefs about death
affect how we live and how we feel and act
in the presence of illness. We need to face
them.
Mary Beth Moster, author of "Living with
Cancer" distinguishes between temporary
hope which has its place—but its limits—in
illness and ultimate hope which is hope in
God. "It is ultimate hope," she says, "that
will give peace.
To Family, Friends, Others
Here are some small ways to help an ill
person:
Call before you visit; say how long you will
stay. Sense when not to visit. As a rule,
make visits short. Be alert to signs of fatigue
or pain.
Sit down. Get at eye level, touch, establish
real contact. Listen. Even a short visit will
have more meaning.
Anticipation is important. Send something
regularly; a note, a card, a prayer, bits of
29
humor or odd information clipped from a
newspaper. But remember, your presence,
when appropriate, is your best gift to a
patient.
Be authentic in what you say. Avoid false
cheeriness or empty words. Saying "You
look great" to a person suffering in body or
spirit is brushing aside his pain: A hug or a
pat^n the arm may say all that needs to be
said.
Offer specific help to the patient or family:
baby-sitting, an errand, a ride.
Avoid criticism of the care the patient is
receiving. It can be upsetting.
Let the patient guide you in his or her needs
and wants, instead of imposing your own
ideas. Ask, "What would you like me to do
for you?" Be available.
Let the patient give you something, however
small or intangible.
Treat the patient as a person, not an illness.
Be aware, as a doctor or nurse, that use of
a patient's first name can be diminishing.
Let a dying patient find the release of
entering into all his or her feelings and
unfinished business. Those close can help
the patient to let his or her life go.
"Pray for one another that you may be
healed." (James 5:16)
As you become a healing person, you have
less need to ask what to say, what to do,
how to cope.
You learn to pray for God's healing power to
work through you.
You move from the position of observer and
enter into the other's experience, sharing it
in some way. You become compassionate.
"He sent them out to preach the kingdom of
God and to heal." (Luke 9:2).
Towards a Healing Community
Where compassionate people are together
as patient, family member, friend, doctor.
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JANUARY-FEBRUARY '81
31
nurse, clergyman, aide or volunteer, there is
concern for each other as persons.
"The whole idea of compassion," said
Thomas Merton, "is based on a keen
awareness of the interdependence of all
these living beings, which are all part of one
another and all involved in one another."
A daughter visits her dying father in a
hospital and finds evidence of neglect. With
respect for them as persons, she invites the
nursing staff into her confidence, sharing
with them her concern for her father, and
the situation is rectified.
A doctor says trust is the physician's
greatest aid. He helps build the patient's
faith in him—and each patient's faith in
himself.
A visitor tell an ill friend he will sit just a
few minutes. He takes his hand.
"Touch is everything. I realized," said the
patient later, "When you're very weak or in
pain."
A volunteer member of a pastoral care
group had trouble at first knowing what to
do when she visited sick people. She prayed
for the key. Eventually she discovered : "To
be there, listen and touch."
A psychiatric nurse prays with her patients.
"You don't rely on psychiatry alone," she
says, "You don't rely on prayer alone......
Prayer can teach people to open themselves
up to God, and then the healing can begin."
God is present in the healing community.
The Christian believes that Jesus the Divine
Saviour took on the suffering experience of
humanity. Healer that he was on earth. He
JANUARY-FEBRUARY '81
called every human being to be the same to
heal one another, to open our hearts to
pain of body and spirit.
"Welcome one another as Christ has
welcomed you for the glory of God.
(Rom. 15:7).
To Patients
Your rights: "k Patient's Bill of Rights"
issued by the American Hospital Association
states, in essence, that a patient has the
right:
To considerate and respectful care with
privacy, confidentiality and reasonable
continuity.
To information about his diagnosis,
treatment and prognosis in understandable
terms; to an explanation of his bill.
To refuse treatment, within legal limits, and
to know the medical consequences of this.
To know hospital rules for patients, to refuse
transfer to another hospital without knowing
the reason for the change.
Your responsibilities: The rights of adult
patients infer responsibilities on their part:
to know and act on these rights, to help
bridge any communication gap, to assert
themselves as mature partners in their own
health care.
New York physician Marvin S. Belsky calls
it getting past the "doctor mystique." To
this end, he holds feedback sessions with
groups of his patients.
Patients should know, too, about home care
services available in their community through
social service agencies, hospitals, volunteer
groups.
Courtesy : "Fr. Agnel's Call"
Dec. 1980, Vol. XXIII No. 12
31
I don't believe in pomp and glory
Bishop Bonaventure
Bishop Bonaventure Paul of Hyderabad Diocese in Pakistan is a giant
of a man, 6 feet and 3 inches tall and weighing well over 200 pounds.
He is in the Franciscan tradition—humble, gay and democratic.
Church of the poor
I won't see the Church of the poor in my
lifetime. We have so many institutions,
things to take care of and we don't know how
to get out of this situation. I struggle with
the problem. If I were alone, I might be able
to do something, but I'm with a group and in
in a group it's hard to do drastic things
because other people are affected.
May be the only the thing to do now is to
have more identification with the poor and
more concern, but I don't see what we can
do now about our structures. And as long as
we have our big buildings, there will always
be a gap between us and the poor, even if
we go to them and show concern.
Emotionally, I know we must do more, but
in reality, structured as we are, we can't
seem to do more.
We must depend on our young priests and
sisters and our youth to create a poor Church
in the future. Our role is to help them seethe
problem and work out with them a vision of
what the Church should be. They have the
commitment.
The ways of a bishop
I don't believe in the pomp and glory that
often surrounds a bishop. When I go to a
village I tell the people, ''There's no need to
construct an alter: it's too much trouble.
I'll say mass sitting on the floor with you,
simply, as one of you."
JANUARY-FEBRUARY '81
I don't go with fancy vestments. These are
external trappings. I eat sitting on their beds
as the people eat. These are just examples. I
find that this breaks down the barriers that
exist between us and the people and they
respect you more, eventually. You're not
hiding behind the pomp of the office. The
people don’t lose respect. They see you want
to be one of them and that you accept them.
Confidence in you grows. They see you as a
person not an official. They may see your
shortcomings, too, but we can't worry about
that.
I feel that after 13 years running this diocese
the people are free to talk with me about
things they wouldn't have talked of before.
A leader should be with the people
encouraging and supporting them, not
imposing. When I feel the people no longer
accept me as a leader, I'll resign. I won't
wait till I'm 75.
I don't believe in laws. I do of course, but
laws are meant to help and are not absolute.
For example, in the tribal villages I often have
confirmation as late as 11 : 00 p.m. Night is
when the people celebrate. I go to the
villages and follow the people's rituals. They
wash my feet, they serve me food and later
they eat. There are more ceremonies and at
about 11 : 00 we have confirmation. The
people sing through the night and in the
morning I go home.
If I insisted on confirmation in the morning,
I would disrupt their customs and lives. A
leader should adjust to the people.
35
I think it's within a bishop's powers to annul
certain types of marriages in his diocese when
the community and priests ask him to do so.
I'm talking about tribals who married as
children in a Hindu rite and now live with
another women. I think a bishop could annul
these on the basis of the ecclesial consent of
the entire community. If the community want
it, I believe a bishop is within his rights to
do so.
Muslim-Christians
We had a privileged set up in the past when
the English were here. Now Islam is finding
its way and so must we. Our people are
insecure but we have no option but to find a
way, because we have to stay here. It's
difficult to see how we will work out our
problems. At best we can have a peaceful
co-existence. We must accept the situation,
yet not give in to injustice. We have to
remember Muslims are 97% of the population.
They feel we have acted as lord and master
for too long. It's not easy to know what
direction to take.
We must break down the gaps that have
opened between bishop and priests on the
one hand and the people. Our older
Christians are verv cleric-oriented. If I
encourage lay leadership, they don't react
positively. They see the bishop as boss, the
priest second in-charge and then the lay
people. With the newer tribal Christians the
bishop, priests and people are one.
We've neglected to study the culture of the
people. We've forbidden them for example, to
sing the old Hindu religious chants. Yet some
are beautiful. One night I left a group around
a fire and went for a walk. The singer was
chanting a Christian version of the old songs.
Later I come back without the people seeing
me. The singer was chanting a touching song
from the Vedas. Finally he saw me. I smiled
and he kept singing. If I had said a word of
criticism, I would have spoiled the evening.
What does it matter ?
[What Bishop Bonaventure says about the
pastroai approach is true also of our healing
ministry. It is heartening to see that today
many of our bishops, priests and religious
also believe in what Bishop Bonaventure
says.—Editor]
“The Laity are worthy of trust”
"The greatest good we can give is the word of God. This does not mean we do not
assist (people) in their physical needs, but it does mean that they need something more and
that we have something more to give : the Gospel of Jesus Christ (partisan politics and
concerted social action should be left to lay Christians). They have a special task to fulfil,
a lofty task, and they need their bishops and priests to support them through spiritual leader
ship. This laity are worthy of trust. They can accomplish what the Lord has assigned to
them."
Pope John Paul 11 to the hierarchy
assembled at the papal nunciature
in Manilla.
JANUARY-FEBRUARY '81
37
CHAI
NEWS
Editor's Note
AS indicated in the convention special issue
of the Medical Service, this issue of our
journal is in your hand with a different out
fit. Some of you may recognise it by the
title. For some it may be just another
periodical that keeps coming. "Our journal
Medical Service should be improved" is an
oft repeated statement during conventions
and discussions. Keeping this in mind we
have tried to bring out this first issue of
1981 in this new form. While presenting to
you this in the new get up, we are fully
aware of the limitations and the room for
improvements. So we expect of our member
institutions to write to us your impressions
on this number, especially by way of
criticism and suggestions for improvement.
With regard to the content part of it, while
focussing to a particular aspect, in this
case, the Year of the Disabled, we would
also like to give as many useful informations
as possible, particularly the involvement by
our member institutions in the field of
Community Health. In this regard let me
once again appeal to those of our member
institutions who are involved in community
health and health education programme to
send a brief report of their activities
together with some photographs, if
available, which could be published in our
journal for the benefit of others. This way,
this house journal of the CHAI becomes
also a forum for our member institutions to
let others share what they do in this
important field.
in this issue we have given some special
attention to the blind. In the guest editorial,
Msgr. Eustace D'Lima, the Deputy Secretary
General of the C B C I has set the good
which our health care institutions and
JANUARY-FEBRUARY '81
NOTES
personnel will have to aim at. This is a
challenge before us and we will have to meet
this challenge. One has to guard against
that we are not carried away merely by the
'celebration' of the year of this and that. We
need to go a step further and meet such
challenges not for this one year, but in a
lasting way.
One point I would like to mention here is
that, while the disabled often get lots of
sympathy and attention, as there are
hundreds of dedicated health care personnel
to take of them, we may have to ask ourselves
a question as to how much we are doing in
preventing this disabilities ? We know that
many of the cases such as blindness,
physical and mental disability etc. can be
prevented if only proper attention and
education is given in time. And we need to
go all out to do it. So our health -care
institution and personnel may have to pay
more attention to health education
programme: This is a greater challenge
before us which we will have to meet
Aid for eye camps
For free eye camps organised in rural areas,
the Royal Commonwealth Society for the
Blind gives financial assistance as below :
1. For the cataract/glaucoma
operation
Rs. 40.00
2. for an optical Iridectomy/
Pterygium/Dachryo cystitis
(or removal of Lacrimal Sac)/
Entropion
Rs. 15.00
3. for a patient treated and other
minor operations
Rs. 1.50
For details please contact:
Royal Commonwealth Society
for the Blind
South Asia Regional Office
B-1/B-3, 2nd Floor, Matru Ashish
Nepean Sea Road, Bombay 400036
39
COMMUNITY HEALTH SEMINAR, Bangalore
Report and Recommendations
The seminar on Community Health,
sponsored by the Ecumenical Christian
Centre in January-February was attended by
40 men and women—doctors, nurses, para
medical workers, representatives from
medical colleges, hospitals and community
health workers involved in tribal, slum and
rural areas from all over India. From CHAI,
Fr. John Vattamattom SVD, the Executive
Director and Sr. Winnifred Ann, one of
the Board Members, participated in the
Seminar. The seminar affirmed that
community health work should be' self—
destructive' and that it should not be
institutionalised. The community health
workers should be prepared to move to
fresh areas at a stage when their services
are not required for the people.
Perspectives
The ultimate aim of the community health
work should be structural change wherein
each person's dignity is honoured and his/
her physical, mental, social and spiritual
well being is taken care of. It should
function as a catalyst creating awareness for
structural change at the grass root level as
well as conscientising or even pressurising
the power structures. The poor people should
be made aware of the extent of the
exploitation and oppression and should be
motivated to fight for their rights.
Approach
Health work should not be done in isolation
from other development activities. Otherwise
it will turn out to be a half hazard patch
work which postpones the radical change
required. Genuine participation of the people
at all levels, in planning and implementation.
Community health programme should be
perventive rather than curative. Periodical
JANUARY-FEBRUARY '81
evaluation of the work will ensure
effectiveness.
Cost
It is high time that community health
workers should resort to cheaper medicines
which the community can afford. Indegenous
medicines should be encouraged as far as
possible. Awareness should be created
among the medical personnel not to be
biased by the propoganda of pharmaceutical
companies. Young doctors should be more
cost benefit oriented in their therapy.
Raising resistance by correcting the
nutritional deficiency by making use of the
locally available food stuffs will go a long
way in preventing diseases. Foreign free drug
should be discouraged.
Personnel and training
The content of the training of the community
health worker should be the simple medical
knowledge. Apart from the medical
education they should be trained how to
educate the community about their rights and
about the exploitative nature of the society
at the micro level. The trainee should be a
person who accept the basic perspectives
of the programmes. He/she should have
leadership qualities. The community health
worker who undergone training should be
acceptable to the community. They should
be paid a fair wage.
Government and other agencies
The community health workers should help
people to obtain the maximum benefit from
the government. In the actual health services
their work should complement rather than
compete with the government or other
agencies. It is highly essential that
duplication should be avoided at all levels:.
Co-operation and common programmes
should be encouraged with groups having
the same perspectives.
41
s
Recommendations
(I)
Bring down the cost of health care and
drugs.
(II)
Indegenous medicine especially the use
of herbal medicine should be
encouraged.
(Ill)
The Christian Medical Association of
India (CMAI) the Catholic Hospital
Association of India (CHAI) and the
Voluntary Hospital Association of
India (VHAI) should work together in
dealing with the problem of community
health especially in—
(IV)
1.
manufacturing low cost medicines
in bulk for the use of non-profit
making service organisations.
2.
-central purchasing and distribution
of drugs.
3.
research and publications.
A forum should be formed to educate
people about the false propaganda,
promotion and use of unnecessary
drugs and tonics.
Christmas Celebration for
Disabled Children
The children's ward of the Sayajirao General
Hospital, Baroda was the venue of the
Christmas celebration for the disabled
children who are under the medical care.
Bishop Ignatius D'Souza of Baroda was the
host of the celebration. When arrived, he
was cordially received by the doctors, nurses
and others. Later, all the staff of the
children's ward were introduced to him.
The Bishop invoked God's blessings on all
those who work in the hospital that through
their good work the sufferings of these
children are alleviated.
He moved around the well-decorated ward
and distributed gifts and sweets to.all the
children. The gifts, he said, where an
expression of his good will towards them.
JANUARY-FEBRUARY '81
Union Government Offers Aid
for Welfare of Disabled
The Union government has offered financial
help to provide aids and appliances on an
extensive scale to the handicapped and has
asked the states to reach the benefits of this
Central programme to the disabled,
particularly in rural and backward areas.
Besides, the ministry of social welfare and
the concerned departments in the states will
each designate a senior official as
commissioner for disabled persons. These
officials will coordinate, promote and monitor
services for the handicapped and keep watch
on utilization of funds.
These announcements were made at the
close of the daylong deliberations of Central
and state ministers who reviewed welfare
programmes for the disabled, women and
deprived children.
They recommended, among other things,
that 100 more Integrated Child Development
Service projects should be launched this
year to bring the total to 300.
The projection is to have 600 ICDS projects
at the end of the sixth plan.
The Ministers further agreed that a national
policy should be formulated to provide
optimum nutrition for every citizen within a
reasonable period with vulnerable groups of
children and mothers receiving priority.
They acknowledged the urgency for
restructing the existing supplementary
nutrition programme by adding essential
inputs like health, immunisation, supply of
safe drinking water, training and monitoring
with adequate financial provisions.
In the context of the observance of the Year
of the Disabled much attention was paid to
their rehabilitation.
Addressing the ministers, Mr. S.B. Chavan
union Minister of Education and Social
Welfare lamented that social
Welfare received a low priority in
allocations. State ministers who spoke after
him asked for increased Central assistance.
43
Mr Chavan told the ministers that the
Government had drawn up a comprehensive
national plan of action to rehabilitate the
handicapped who "for centuries have been
segregated and often stigmatised/* The
government strategy according to him, would
be to integrate the disabled with the
mainstream of society by providing them
with education, equipment, training and jobs.
Continuous Evaluation
Further, he called for a continuous evaluation
programme of projects meant for women and
suggested a target-oriented approach.
Ministers from Andhra Pradesh, Gujarat,
Karnataka and Maharashtra spoke of the
special efforts in this direction, particularly
tor their economic improvement through
assistance by special corporations.
On the proposed national nutrition policy,
Mr Chavan explained that the objective was
to "reduce the rate of infant and
child mortality and morbidity and develop
better human resources."
The minister maintained that social
development should not be considered as a
residuary sector as it cut across various
sectors of development. Inter-sectoral
linkages and inter-department endeavour
would provide fruitful dividends.
He also pointed out that in the assessment of
the national effort for social welfare
programmes not only of his ministry but also
of ministries like health, education and
housing as also the contributions made by
voluntary agencies should be reckoned.
Anti-Leprosy Vaccine
An anti-leprosy vaccine is possible in the near
future, according to Prof M.G. Deo, director
of the Cancer Research Institute, Bombay.
Experiments are being carried out on albino
mice and tissue cultures were developed at
the Tata Cancer Research Centre in
coordination with noted leprosoriums. The
results seem encouraging and there is the
possibility of developing such vaccine.
JANUARY-FEBRUARY '81
Major Recommendations of the
Chief Ministers Conference
(Jan.1981)
Major recommendations of the Chief
Ministers Conference to be implemented at
the Central and State levels included, high
priority for reservation of three per cent of
the jobs in public employment for the
handicapped : opening of more employment
exchanges for them : implementation of a
plan of action for their resettlement by every
state; establishment of committees in every
state for utilization of the national children's
fund; provision of better children's homes;
continued follow-up action on the programme
laid down during the International Year of
the Child; the liberal assistance to
voluntary organisations for constructing
working women's hostels.
Dr. U. Ko Ko
New Regional Director of WHO
Dr. U. Ko Ko, former WHO regional Director,
health services, took over from Dr. V.T.H.
Gunaratne, as regional Director, WHO
South-East Asia Region with effect from
March 1, 1981.
Dr. Ko Ko, had earlier worked with the
Burmese government in various capacities in
health service schemes, teaching and
research. He represented that country at
several international meetings and
conferences organised by the WHO and was
elected vice-president of the World Health
Assembly in 1968.
Dr. Ko Ko, joined the WHO South-East Asia
regional office in 1969 as adviser in
community health services and in 1978 took
over as director, health services, in which
capacity he served till his appointment as
regional director.
45
LIST OF NEW MEMBERS
St. Theresa's Dispensary
Pamarru P.O.
Krishna Dist.
Andhra Pradesh 521 157.
Seva Sadan
Y-19 Rourkela
Sundargarh Dist.
Orissa 769 004.
C.H.F. Health Centre
Holy Family Generalate
Mannuthy P.O.
Trichur Dist.
Keraia 680 651.
Pushpa Swasthy Kendra
Sikandra Post
Monghyr Dist.
Bihar 811 315.
St. Ann's Health Centre
Appanapet-Peddapal ly
Karimnagar Dist.
Andhra Pradesh 505 177.
St. Paul's Dispensary
Utnoor P.O.
Adilabad Dist.
Andhra Pradesh 504 311.
Enrichetta Health Centre
Teganare' Talavadi P.O.
Periyar Dist.
Tamil Nadu 638 461.
Jeevan Jyothi Health Centre
Semiliguda P.O.
Koraput Dist.
Orissa 764 036.
Fabio Dispensary
C/o Holy Family Convent
Rongjeng P.O.
East Garo Hills Dist.
Meghalaya 793 007.
Lourde's Aroghya Kendra
Nagavally, Kogar P.O.
Kargal Via
Shimoga Dist.
1
T2
Karnataka 577 421.
St. Theresa's Dispensary
Dewra, Bhamara P.O.
Rewa Dist.
Madhya Pradesh 486 445.
Shanti Niketan Health Centre
Khandwa P.O. & Dist.
Madhya Pradesh 450 001.
St. Joseph's Clinic.
C/o St. Joseph's Church
Pernem
Goa 403 512.
Bro. Paul's Dispensary
Kailathipura P.O.
Chickmangalur Dist.
Karnataka 577 129.
Sagarose Dispensary
St. Thomas Church
Vembar
Tirunelveli Dist.
Tamil Nadu.
don’t WORRY'
I HAVE DOA/E
Ah/UMBEROE
THESE
.r.
OPERATION
fl SUCCESSFUL!
JANUARY-FEBRUARY '81
Dr. Gunaratne Receives
International Award
The prestigious Award of the International
Agency for the Prevention of Blindness was
presented to Dr. V.T.H. Gunarantne,
Ex-Regional Director, WHO South-East Asia
Region on February 13, 1981 in New Delhi
by Sir John Wilson, President of the
Agency.
The International Award, a brilliant crystal
orb mounted on a silver stand, is the highest
honour conferred by the Agency and has so
far been presented only four times—on each
occasion to one of the world's leading eye
specialists. Dr. Gunaratne is the first member
of any United Nations agency to receive
such honour.
Presenting the award at the conclusion of a
meeting of international experts attending
the WHO Programme Advisory Group, Sir
John Wilson said that this was in
recognition of the outstanding contributions
made by Dr. Gunaratne during his years as
Regional Director to the prevention of
blindness throughout Asia, and the support
he gave to this cause. Sir John assured
Dr. Gunaratne that the award "comes with
the appreciation and gratitude of all who are
concerned with the prevention of blindness
and with the blessing of millions throughout
Asia who, through the work you have
supported, may be saved from the tragedy
of needless blindness."
The International Agency for the Prevention
of Blindness has national committees in 57
countries and regional organizations in every
continent. In partnership with agencies
like WHO, it is engaged in a global effort
to control the main causes of blindness
which now afflict 42 million people in the
world.
rights of disabled persons
Disabled persons have the inherent right to
respect for their human dignity. Disabled
persons, whatever the origin, nature and
seriousness of their handicaps and disabili
ties, have the same fundamental rights as
their fellow-citizens of the same age, which
implies first and foremost the right to enjoy
a decent life, as normal and full as possible.
Disabled persons have the same civil and
political rights as other human beings; para
graph 7 of the Declaration on the Rights of
Mentally Retarded Persons applies to any
possible limitation or suppression of those
rights for mentally disabled persons.
Disabled persons are entitled to have their
special needs taken into consideration at all
stages of economic and social planning.
Disabled persons have the right to live with
their families or with foster parents and to
participate in all social, creative or recreati
onal activities. No disabledAfgerson shall be
subjected, as far as his or her residence is
concerned, to differential treatment other
than that required by his or her condition or
by the improvement which he or she may
derive therefrom. If the stay of a disabled
person in a specialized establishment is indis
pensable, the environment and living condi
tions therein shall be as close as possible to
those of the normal life of a person of his or
her age.
Disabled persons shall be protected against
all exploitation, all regulations and all treat*"*
ment of a discriminatory, abusive or degrad
ing nature.
Disabled persons, their families and commu
nities shall be fully informed, by all appro
priate means, of the rights contained in this
Declaration.
Excerpts of 2433rd plenary meeting of the
U N General Assembly 9 December 1975.
MEDICAL SERVICE
Position: 2866 (4 views)